Income distribution and mortality: Implications from a comparison of individual-level analysis and multilevel analysis with Swedish data

Göran Henriksson · Peter Allebeck · Gunilla Ringbäck Weitoft · Dag Steinar Thelle

18 citations0/0 files storedScandinavian Journal of Social Medicine

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Health disparities and outcomes Employment and Welfare Studies Public Health and Social Inequalities

Abstract

BACKGROUND: This follow-up study analyses whether there is an association between income distribution in Swedish municipalities and risk of death from all causes in the total Swedish population aged 40-64 years and compares the results obtained with analyses performed on individual-level analysis and multilevel analysis. METHODS: Individual-level data on social and economic circumstances were obtained from various official records and were linked to the national cause-of-death register. Analyses were made with two methods, an individual-level regression and a multilevel regression. The study population comprised all people 40-64 years of age in the 1990 Swedish census, altogether 2.57 million people in 284 municipalities. RESULTS: The main results showed that in the individual-level regression the income distribution showed a positive and significant association (risk ratio = 1.29; 95% CI = 1.24-1.34) with higher mortality for those living in municipalities with higher income inequality. This association was not found in the multilevel regression analysis (RR = 1.03; 95%CI = 0.94-1.13). CONCLUSION: There seems to be no association between income distribution and mortality in Sweden when considering the possibility of clustering in municipalities. Further studies on the relationship between income inequality and health should aim at elucidate processes within area-level units.

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References

2000Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions 2004Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review 2004Income Inequality and Health: What Have We Learned So Far?2002Income inequality and population health 2001Psychosocial and material pathways in the relation between income and health: a response to Lynch et al 2000Ecological approaches: the rediscovery of the role of the physical and social environment 2000Ecological Approaches: Rediscovering the Role of the Physical and Social Environment 2002Income inequality, individual income, and mortality in Danish adults: analysis of pooled data from two cohort studies

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